A surge in flu cases in south-central Minnesota prompted 14 hospitals in that area Wednesday to restrict visitors to protect patients and staff from the viral infection. The region is currently experiencing flu patient volumes that in some locations exceed the peak of the H1N1 outbreak in 2009.

Kevin Burns, regional director of public affairs for Mayo Clinic Health System, said beginning immediately the following restrictions apply:

• Visitors are limited to immediate family members (patient spouse or significant other, parent, sibling or child)

• Limit of two visitors per patient at a time

• No one who is ill (has symptoms of influenza including fever or chills, muscle or body aches, sore throat, cough, stuffy nose, headache and fatigue) will be permitted to visit

Burns said the visitor restrictions are similar to those implemented during the 2009 pandemic. He said United Hospital District in Blue Earth is the only south-central Minnesota hospital that has not adopted the same visitor restrictions.

A spokesperson for the Blue Earth hospital said flu cases surged around Christmas, but they have not had enough cases recently to warrant visitor restrictions.

Health care providers in the area are also urging businesses to relax their absentee policies. Burns said businesses could make it a lot easier on hospitals, clinics and urgent care locations if they did not require employees to bring in a provider note explaining their flu absence.

"Health care providers throughout our region are very busy and very active caring for patients and their families, and if we can reduce the paperwork at least temporarily that will be a more efficient and effective use of health care professionals' time and more efficient and effective for getting employees back to work in a timely manner," Burns said.

Health providers are also encouraging schools in south central Minnesota to encourage hand washing and urge parents to keep their sick children home.

SO FAR, A MODERATE FLU SEASON

Minnesota's flu season may seem unusual given the severity of some cases and the recent surge in the disease. But aside from the early start to the season, public health officials say the influenza picture that's developing appears to be pretty typical even though our recent mild flu years may have made it seem like flu is nothing to get too concerned about.

Kris Ehresmann, director of Infectious Disease Epidemiology at the Minnesota Department of Health, said at a minimum this appears to be a moderate flu season. Although she thinks it's more likely that it will be classified as severe by the time the season ends in late May.

"We're seeing what influenza can be and it's not an insignificant illness. It can be very severe. And this year is really just a reminder of that," Ehresmann said.

Health Department statistics show that the predominant flu strain circulating in Minnesota is H3N2. This type-A flu virus circulated widely in the state a few years ago. It does tend to be especially hard on elderly people, but anyone can get it.

Ehresmann said it was squeezed out for awhile after the pandemic flu virus, H1N1, showed up in 2009. Now H3N2 has taken over again.

A version of the H1N1 pandemic virus is also circulating this year, although it is now considered to be a seasonal type-A flu virus. Some people in Minnesota have also been infected with a B-strain of flu.

FLU SHOT WELL-MATCHED FOR STRAINS

For now it appears that the flu vaccine is well-matched to the circulating strains of influenza. The U.S. Centers for Disease Control and Prevention reported in a study that 92 percent of the viruses its scientists have cultured do match the vaccine. In addition, the Minnesota Health Department says most of the virus cultures it has grown also match well with the vaccine.

Yet, getting vaccinated doesn't guarantee that a person won't get flu. On average the vaccine is about 60 percent effective according to a study done in Minnesota. Some of the people who have been hospitalized with the flu this season have been vaccinated. For example, people who are 65 years and older have some of the best flu vaccination rates in the state — over 75 percent — and yet most of the people who have been hospitalized for flu are over age 65.

Still, according to Ehresmann, even if the vaccine is not perfect, it is better than nothing.

"Sometimes what can happen with vaccination is that although it doesn't keep you from getting the actual disease, sometimes it can help to make it milder," Ehresmann said.

RISK GREATER FOR ELDERLY, OTHERS

Some who have been vaccinated still developed very severe infections. Some of this variation in effectiveness could depend on the strength of a person's immune system or if the individual was exposed to other dangerous infections while recovering from the flu.

Pregnant women are some of the most susceptible people to complications from flu.

"Because of the changes taking place in their body being pregnant and changes in circulation," Ehresmann said. "Your whole system is changing to accommodate another life."

But the group experiencing the highest number of flu complications is people age 65 and older. They represent 57 percent of the adults who have been hospitalized for flu this season.

Infants and young children and people with chronic health conditions are also at greater risk for more serious influenza and greater complications from flu.

The Health Department said there is still time to get vaccinated for flu as there are still several months left in the flu season. There are currently no shortages of the vaccine in Minnesota.

If detected early, flu can be treated with antiviral medications to lessen the severity of the infection. The Health Department says there have been a few spot shortages of antiviral drugs, but the agency says shortages have not been widespread.

SHORTAGE NOT A SUPPLY ISSUE

A few pediatric clinics in Minnesota are running out of their privately purchased supply of flu vaccine and having trouble finding additional doses. The state heatlh department said the clinics still have doses of publicly purchased flu vaccine that are typically reserved for low-income children as part of the Minnesota Vaccines for Children program.

The situation is not a vaccine shortage, but an accounting issue that can be quickly resolved, Ehresmann said.

"What we're recommending to them is that they can use some of their public vaccine supply so that they can continue to provide immunizations seamlessly while they are waiting for their private supply to be restocked," Ehresmann said.

She said clinics must document what they take from their public vaccine stockpile and backfill those doses when their vaccine order is replenished. She says clinics are also prohibited from using any of their public flu vaccine supply to immunize adults.